Provider Demographics
NPI:1306409297
Name:BISHOP, CATHY LYNNE (MAC, ADM, CDCS, ABHC)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:LYNNE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:MAC, ADM, CDCS, ABHC
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:LYNNE
Other - Last Name:CAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 876741
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-6741
Mailing Address - Country:US
Mailing Address - Phone:907-373-4732
Mailing Address - Fax:
Practice Address - Street 1:7010 E BOGARD RD
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-4711
Practice Address - Country:US
Practice Address - Phone:907-373-4732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health